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Published on: June 11, 2012

Effect of hospital admission on glycemic control 1 year after discharge

Nancy J Wei1, Richard W Grant, David M Nathan

  • 1Diabetes Center, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts 02114, USA. ncwei@partners.org

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|July 19, 2012
PubMed

Insights

Hospital admission did not significantly alter long-term glycemic control trends in diabetes patients. However, hospitalized individuals were less likely to reach target hemoglobin A1c levels one year post-discharge.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Clinical Medicine

Background:

  • Diabetes mellitus management requires continuous monitoring of glycemic control.
  • Hospitalization can disrupt routine diabetes care and impact long-term health outcomes.
  • Assessing the effect of inpatient stays on diabetes control is crucial for patient management.

Purpose of the Study:

  • To evaluate the impact of hospital admission on glycemic control in patients with diabetes.
  • To compare glycemic control trajectories up to one year after discharge between hospitalized and non-hospitalized individuals.
  • To identify factors influencing the achievement of glycemic targets post-hospitalization.

Main Methods:

  • Retrospective analysis of 826 hospitalized and 826 matched non-hospitalized adults with diabetes.
  • Collected hemoglobin A1c (A1C) data from 6 months pre-admission to 1 year post-discharge.
  • Utilized multivariate random effects models and logistic regression for data analysis.

Main Results:

  • No significant difference in the mean rate of A1C change between hospitalized and non-hospitalized patients over one year.
  • Hospitalized patients were less likely to achieve A1C goals of ≤7% (OR, 0.68) or <8% (OR, 0.62) at one year.
  • Patients with baseline A1C ≥9% showed a trend of -0.10% monthly A1C change, irrespective of hospitalization.

Conclusions:

  • Hospitalization does not alter the overall trend of glycemic improvement over time.
  • Hospitalized patients with uncontrolled diabetes face greater challenges in achieving long-term glycemic targets.
  • There is a potential missed opportunity to optimize long-term diabetes management during hospital admissions.
Abstract

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